Oregon Psychiatrist Warns of Health Dangers from Impact of Climate Change

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It is perhaps no small irony that Oregon psychiatrist and climate change advocate David Pollack, M.D., spent much of September prepared to evacuate his home as the result of a catastrophe stemming from climate change.

“Wildfires were burning all over the state,” he told Psychiatric News. “The most immediate problem was the amount of time needed to fight these fires and the shortage of trained personnel to fight them. My wife and I were on alert to evacuate our home if the fires would have spread farther to the west.”

One fire began on Labor Day, just a mile east of Pollack’s home, with strong winds heading their way. Fortunately, the winds suddenly shifted, and the fire was contained before evacuation became necessary, he said, noting that some of his neighbors were sheltering hundreds of horses, cattle, and goats that had been evacuated from areas to the east.

For six months before the outbreak of the wildfires, the COVID-19 quarantine kept Pollack and his wife sequestered in their home and gardens just south of Portland. Highly unusual Labor Day windstorms, smoke, and ash kept them indoors for almost two weeks with all vents sealed from the outside, Pollack said.

Scientists and climate change experts have agreed that record-breaking fire activity on the West Coast in recent years and in other parts of the world—the Australia bushfires in 2019 and 2020, for instance—have been caused, in part, by drought, increased lightning, and other factors resulting from climate change.

The convergence of wildfires, hurricanes, infectious disease pandemics, and social and structural inequities are interrelated, Pollack noted. “The pandemic and weather events are harbingers of more frequent and serious harms, including threats to our individual and collective mental health,” Pollack said.

“Some of the impact is clear. I sit in a house unable to leave due to hazardous air quality, while others around me are more directly traumatized by the wildfires,” he said. “It is harder for people to see that climate change is a slow-moving mega-disaster unless we speed up time, so we can see it clearly for the catastrophe it truly is.”

Pollack, who is professor emeritus for public policy at Oregon Health and Science University, has worked for years with climate activists in psychiatry to educate medical colleagues, other mental health professionals, and the public about the adverse mental health effects of the climate crisis.

“The increased frequency and severity of extreme weather events around the world, such as hurricanes, wildfires, heatwaves, heavy precipitation, and air pollution result in anxiety, trauma, depression, worsening of psychosis, increased substance use, violence, and suicide,” Pollack noted.

His experience with the mental health consequences of disasters began when he was stranded at a conference on the East Coast following the September 11, 2001, terrorist attacks. Pollack managed to get to New York City to help triage and support survivors in the immediate aftermath of the attacks. Later, as medical director of Oregon’s Office of Mental Health and Addiction Services, he became the point person for mental health disaster response in the state. In this role, he and his colleagues developed disaster response protocols and training.

“Our planning efforts were put into practice in the aftermath of Hurricane Katrina in 2005, when more than 1,000 evacuees from New Orleans and Houston came to Portland,” he said.

In 2017 he and several other psychiatrists from around the country co-founded the Climate Psychiatry Alliance (CPA). The CPA educates psychiatrists and other physicians, mental health professionals, and the public about the mental health risks of the climate crisis. Members of the CPA travel to district branches, universities, and hospitals to educate colleagues and develop curricula for health professional training sites. In addition, CPA members have written articles on climate change and mental health for Psychiatric News and other publications.

CPA members worked with APA to establish its Caucus on Climate Change and Mental Health in 2018. The caucus has introduced several key policy proposals that have been approved by the APA Assembly, Pollack noted, including a commitment from APA to divest from fossil fuel investments, as well as to develop model curricula on climate change and mental health and promote research on climate change. The caucus and CPA members have also provided numerous sessions on climate change issues at APA’s IPS: The Mental Health Services Conference and APA’s Annual Meeting.

According to Joshua Morganstein, M.D., who chairs APA’s Committee on the Psychiatric Dimensions of Disaster, this education of health professionals is vital. “The adverse mental health effects of these climate-related disasters are well established, impacting more people across a broader geography and across a much longer span of time than all other health effects related to these events,” he noted. “Distress reactions, risky health behaviors, and psychiatric disorders represent the range of adverse mental health effects following these events, most of which present in non-mental health settings, such as primary and emergency care. It is important for health care personnel across multiple disciplines to understand the range of adverse effects and those who are most vulnerable, which includes patients dependent on systems of care, individuals with active and uncontrolled mental health and substance use symptoms, people of lower socioeconomic status, and people within marginalized communities.”

A number of national and international climate reports have emphasized the harmful effects of climate change on health and mental health in recent years, including the World Health Organization’s Health and Climate Change report, the annual U.S. National Climate Assessment, the UN’s Intergovernmental Panel on Climate Change, and the Lancet Countdown on Health and Climate Change report. In addition, the New England Journal of Medicine published an interactive module called “Climate Change and Health,” which Pollack characterized as an excellent teaching tool for health professionals.

“If we don’t implement effective climate change policies and prepare our communities for the reality of the climate crisis, the situation will inexorably worsen,” Pollack said. “In spite of the Paris Accord and other international efforts to address the climate crisis, most international initiatives have been slow and relatively weak. Witnessing the current administration’s regressive and counterproductive agenda has been even more distressing. Our challenge is greater than can be imagined, and we must face it earnestly and honestly to instill hope and motivate the collective effort needed to save our planet and humanity.

“Psychiatrists are critical participants in that process,” he concluded. ■